- citati u SCIndeksu: 0
- citati u CrossRef-u:0
- citati u Google Scholaru:[
 ]
- posete u poslednjih 30 dana:8
- preuzimanja u poslednjih 30 dana:3
|
|
|
2020, vol. 37, br. 2, str. 180-190
|
|
Stopa i uzroci smrtnosti majki u južnom Iranu
Maternal mortality rate and its causes in the south of Iran
aShiraz University of Medical Sciences, School of Health, Department of Epidemiology, Non-Communicable Diseases Research Center, Shiraz, I.R. Iran bShiraz University of Medical Sciences, Shiraz Geriatric Research Center, Shiraz, I.R. Iran cShiraz University of Medical Sciences, Office of Vice Chancellor for Health Affairs, Shiraz, I.R. Iran dShiraz University of Medical Sciences, Student Research Committee, Shiraz, I.R. Iran eUniversity of Texas Health Science Center at San Antonio, Department of Neurosurgery, San Antonio, Texas, USA fShiraz University of Medical Sciences, Institute of Health, Health Policy Research Center, Shiraz, I.R. Iran
e-adresa: moghadami@sums.ac.ir
Projekat: The authors would like to acknowledge the research vice-chancellor of Shiraz University of Medical Sciences for cooperation and the financial support of dissertation proposal number 91-6314.
Sažetak
Stopa smrtnosti majki obično odražava stepen razvoja jedne zemlje. U ovoj studiji prikazana je incidencija (stopa) smrtnosti majki i razmatrani su povezani faktori rizika u provinciji Fars, na jugu Irana. Primenom sistema za nadzor Univerziteta medicinskih nauka u Shirazu, pregledani su kartoni novorođene dece u periodu od 2002. do 2012. godine, kada je zabeležena i smrtnost majki. Od 747.077 trudnoća, prosečna stopa smrtnosti majki iznosila je 21,28 na 100.000 novorođene dece godišnje, pri čemu je uočen smanjen i nesignifikantan trend. U ruralnim oblastima, stopa smrtnosti majki bila je duplo veća nego u gradskim oblastima. Najčešći uzrok smrtnosti majki bili su krvarenje (27%), zatim preeklampsija (15,7%) i infekcije (13,2%). Premda se stopa smrtnosti majki smanjila, smanjenje nije signifikantno. Na osnovu povećane stope smrtnosti majki u ruralnim oblastima, trebalo bi poboljšati negu majki, naročito posle porođaja. Krvarenje je i dalje glavni uzrok smrtnosti majki u provinciji Fars. S obzirom na to da se visok procenat ovakvih slučajeva može sprečiti, pojačana zdravstvena nega tokom trudnoće, smanjenje broja carskih rezova, bolja opremljenost zdravstvenih ustanova, kao i postojanje timova za kontrolu krvarenja u porodilištima, verovatno će značajno uticati na stopu smrtnosti majki.
Abstract
The maternal mortality rate (MMR) often reflects the development status of one country. This study calculates the incidence rate of maternal mortality and examines the related risk factors in Fars Province, located in South of Iran. Using the surveillance system of Shiraz University of Medical Sciences, we reviewed all childbirth records from 2002 to 2012 in which maternal mortality occurred. Of 747,077 pregnancies, the average MMR was 21.28 per 100,000 live births per year, with a decreasing but non-significant trend. In rural areas, the MMR was more than twice as high as in urban areas. The most common cause of maternal death was maternal hemorrhage (27%), followed by pre-eclampsia (15.7%) and infections (13.2%). Although the MMR gradually decreased, this decrease was not significant. Based on the higher MMR in rural areas, maternal and specialty post-partum care in rural areas should be improved and promoted. Hemorrhage is still the main cause of maternal mortality in Fars Province. Since high percentage of these cases are preventable, increased healthcare during pregnancy, reduction of cesarean sections, more well-equipped facilities, and hemorrhage-control teams in maternity hospitals would likely have a significantly positive impact on MMR.
|
|
|
|
Reference
|
|
  
|
Abouzahr, C. (2011) New estimates of maternal mortality and how to interpret them: choice or confusion. Reprod Health Matters, 19(37):117-28
|
|
|
Bartlett, L.A., Mawji, S., Whitehead, S., Crouse, C., Dalil, S., Ionete, D., Salama, P. (2005) Where giving birth is a forecast of death: Maternal mortality in four districts of Afghanistan, 1999-2002. Lancet, 365(9462): 864-870
|
|
|
Barton, J.R., Sibai, B.M. (2012) Severe sepsis and septic shock in pregnancy. Obstetrics & Gynecology, 120(3): 689-706
|
|
|
Bricker, L., Medley, N., Pratt, J.J. (2015) Routine ultrasound in late pregnancy (after 24 weeks' gestation). Cochrane Database of Systematic Reviews, (6)
|
|
|
Cunningham, F.G., Leveno, K.J., Bloom, S.L., et al. (2014) Williams obstetrics. New York: McGraw Hill professional
|
|
|
Delavar, B., Azemikhah, A., Eslami, M. (2005) Integrated monitoring and evaluation system for reproductive health programs. Tehran: Ministry of Health and Medical Education
|
|
1
|
Deneux-Tharaux, C., Carmona, E., Bouvier-Colle, M., Bréart, G. (2006) Postpartum maternal mortality and cesarean delivery. Obstetrics & Gynecology, 108(3, Part 1): 541-548
|
|
|
Dumont, A., Fournier, P., Abrahamowicz, M., Traoré, M., Haddad, S., Fraser, W.D. (2013) Quality of care, risk management, and technology in obstetrics to reduce hospital-based maternal mortality in Senegal and Mali (QUARITE): A cluster-randomised trial. Lancet, 382(9887): 146-157
|
|
|
Gholami-Taramsari, M. (2008) Ten-year evaluation of maternal mortalities in Kohgiluyeh and Boyerahmad province. Knowledge Health, 3(2):33-7
|
|
|
Goodburn, E., Campbell, O. (2001) Reducing maternal mortality in the developing world: Sector-wide approaches may be the key. BMJ, 322(7291): 917-920
|
|
|
Harper, M.A., Byington, R.P., Espeland, M.A., Naughton, M., Meyer, R., Lane, K. (2003) Pregnancy-related death and health care services. Obstetrics & Gynecology, 102(2): 273-278
|
|
|
Hawkins, J.L., Chang, J., Palmer, S.K., Gibbs, C.P., Callaghan, W.M. (2011) Anesthesia-related maternal mortality in the United States: 1979-2002. Obstetrics & Gynecology, 117(1): 69-74
|
|
|
Hirst, J., Jeffery, H. (2013) Education, audit, and outreach to prevent maternal mortality. Lancet, 382(9887): 108-110
|
|
|
Hogan, M.C., Foreman, K.J., Naghavi, M., et al. (2010) Maternal mortality for 181 countries, 1980-2008: A systematic analysis of progress towards Millennium Development Goal 5. Lancet, 375 (9726):1609-23
|
|
|
King, J.C., ed. (2012) Maternal mortality in the United States: Why is it important and what are we doing about it?. Seminars in Perinatology, 36(1): 14-18, Elsevier
|
|
|
Lee, Q.Y., Odoi, A.T., Opare-Addo, H., Dassah, E.T. (2012) Maternal mortality in Ghana: A hospital-based review. Acta Obstetricia et Gynecologica Scandinavica, 91(1): 87-92
|
|
|
Li, X.F., Fortney, J.A., Kotelchuck, M., Glover, L.H. (1996) The postpartum period: The key to maternal mortality. International Journal of Gynecology & Obstetrics, 54(1): 1-10
|
|
|
Merdad, L., Hill, K., Graham, W. (2013) Improving the measurement of maternal mortality: The sisterhood method revisited. PLoS One, 8(4): e59834-e59834
|
|
|
Ministry of Health and Medical Education (MHME) (2009) Annual report of rural vital horoscope. http://www.hbi.ir/default.aspx?templateid=0 [2014 Apr. 5]
|
|
|
Moosazadeh, M., Nekoei-Moghadam, M., Emrani, Z., Amiresmaili, M. (2014) Prevalence of unwanted pregnancy in Iran: A systematic review and meta-analysis. International Journal of Health Planning and Management, 29(3): e277-e290
|
|
|
Moradan, S., Forouzesh, F.M. (2012) Prevalence and causes of maternal mortality in a 10-year period in a university hospital in Semnan. Iran J Obstet Gynecol Infertil, 15(3):1-7
|
|
|
NOCR (2014) Vital statistics events. http://www.sabteahval.ir/en [Sep. 13]
|
|
|
O'Dwyer, V., Hogan, J.L., Farah, N., Kennelly, M.M., Fitzpatrick, C., Turner, M.J. (2012) Maternal mortality and the rising cesarean rate. International Journal of Gynecology & Obstetrics, 116(2): 162-164
|
|
|
Rahman, S.U., Ahmed, B. (2013) Perinatal service in the State of Qatar. Journal of Health & Medical Informatics, s11(2)
|
|
|
Rashidian, A., Khosravi, A., Khabiri, R., et al. (2012) Islamic Republic of Iran's Multiple Indicator Demographic and Healh Survey (IrMIDHS) 2010. Tehran: Ministry of Health and Medical Education, 83-6
|
|
1
|
Ronsmans, C., Etard, J.F., Walraven, G., Hoj, L., Dumont, A., Bernis, L., Kodio, B. (2003) Maternal mortality and access to obstetric services in West Africa. Tropical Medicine and International Health, 8(10): 940-948
|
|
|
Ronsmans, C., Graham, W.J., group LMSSs (2006) Maternal mortality: Who, when, where, and why. Lancet, 368(9542): 1189-1200
|
|
|
Roudi-Fahimi, F. (2003) Women's reproductive health in the Middle East and North Africa. Washington, DC: Population Reference Bureau
|
|
|
Shiraz University of Medical Sciences (SUMS) (2014) http://www.sums.ac.ir/fars-provience [2014 Apr. 5]
|
|
|
Solheim, K.N., Esakoff, T.F., Little, S.E., Cheng, Y.W., Sparks, T.N., Caughey, A.B. (2011) The effect of cesarean delivery rates on the future incidence of placenta previa, placenta accreta, and maternal mortality. Journal of Maternal-Fetal & Neonatal Medicine, 24(11): 1341-1346
|
|
|
van Lerberghe, W. (2005) The World Health Report 2005: Make every mother and child count. World Health Organization
|
|
|
WH Organization (2012) Trends in maternal mortality: 1990 to 2010: WHO, UNICEF, UNFPA and the World Bank estimates
|
|
|
WH Organization, UNICEF (2007) Maternal mortality in 2005: Estimates developed by WHO, UNICEF, UNFPA, and the World Bank
|
|
|
WH Organization (2010) Trends in maternal mortality: 1990 to 2008: Estimates developed by WHO, UNICEF, UNFPA and the World Bank
|
|
|
World Health Organization (WHO) (2014) Maternal mortality. http://www.who.int/mediacentre/factsheets/fs348/en/ [2015 May 18]
|
|
7
|
World Health Organization (2004) International statistical classification of diseases and related health problems
|
|
|
|
|